NPIMap

Organization Active NPI

Long Pond Pediatrics

  • Pediatrics Physician
  • Rochester, NY
National Provider Identifier
1588765952
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LONG POND PEDIATRICS
Practice address
3 Saredon Place
Suite 100
Rochester, NY 14606
Phone
(585) 225-0950
Fax
(585) 225-9093
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maryanne Kiernan, MD
Title
Financial Officer
Phone
(585) 225-0950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3 Saredon Place
Suite 100
Rochester, NY 14606

Mailing address

3 Saredon Place
Suite 100
Rochester, NY 14606
Phone (585) 225-0950

Other identifiers 1

IdentifierTypeStateIssuer
02223729MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0983075Long Pond Pediatrics LLP3 Saredon Place Suite 100, Rochester, NY 14606Provider-performed microscopyFeb 12, 2027

National Provider Directory

National Provider Directory

Locations

1255 Portland Ave
Rochester, NY 14621
Phone (585) 342-8700

181 Lomb Memorial Dr
Ste 78
Rochester, NY 14623

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1588765952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAREDON PLACE",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14606",
            "telephone_number": "585-225-0950",
            "fax_number": "585-225-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAREDON PLACE",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14606",
            "telephone_number": "585-225-0950",
            "fax_number": "585-225-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG POND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "KIERNAN",
        "authorized_official_first_name": "MARYANNE",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "585-225-0950",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02223729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.